Substance Use Services / SATU—Substance use and Addiction Treatment Unit

Overview

SATU—Substance use and Addiction Treatment Unit, a satellite clinic of the Connecticut Mental Health Center (CMHC), is a cooperative endeavor between the Connecticut Department of Mental Health and Addiction Services and Yale University School of Medicine’s Department of Psychiatry. Training in the Substance Use Services Track can happen as either a primary or secondary placement and allows for a unique combination of experiences. Placement at the SATU Clinic affords fellows the opportunity to work in an outpatient setting and learn cutting edge treatments for substance use disorders, to have access to world renowned faculty in the Division of Addictions Research, and to develop leadership skills in addictions administration.

Placement Options

Primary Placement - Entails substance use outpatient experience for a full year, 30 hours per week, as a primary placement which is combined with your choice of one of the following secondary placements: Consultation, Prevention & Program Evaluation Services / The Consultation Center; Adult Community Mental Health Services / 34 Park Street; Child & Adolescent Services / West Haven Mental Health Clinic.

Secondary Placement - Entails 15 hours per week of substance use outpatient experience as a secondary placement, which is combined with a primary placement at Consultation, Prevention & Program Evaluation Services / The Consultation Center.

Number of Fellows

Primary Placement: 2

The Setting

Since 1968, SATU—Substance use and Addiction Treatment Unit has been at the forefront of the nation’s efforts to assess and treat substance use disorders. Locally, SATU is a leader in providing education, consultation, and mentorship to community agencies and city and state government. The clinic serves a racially, ethnically, and economically diverse population of adult clients from New Haven and surrounding communities. Additionally, specialty services are offered for health care providers with addictions from across the state who have been identified by the Department of Public Health as needing assessment and long-term treatment for substance use problems.

The clinic staff is a diverse and compassionate multidisciplinary team that provides the following services in English, Spanish, and Portuguese: diagnostic evaluation; crisis management; pharmacotherapy; case management; psychotherapy for individual, group, and families; consultation; and referral to appropriate levels of care. Group offerings at SATU include Cognitive Behavioral Therapy, Life Skills Group, Mindfulness for Relapse Prevention, Spirituality, Health and Recovery, Harm Reduction, Motivational Enhancement, 12 Step Group, Auricular Acupuncture, Smoking Cessation, Latino Therapy Groups, and Gender Specific Trauma Groups.

The Internship

Fellows placed at SATU function as members of a large outpatient team, and participate in all aspects of providing community-based care. Primary responsibilities include the provision of clinical assessment services, individual and group psychotherapy, and case management and referral services.

Fellows evaluate clients who walk into SATU requesting clinical services. While working in this fast paced environment, fellows gain proficiency in: rapid assessment; management of acute substance use, psychiatric, and psychosocial issues; and consultation and referral.

Following the triage evaluation, clients with a wide range of psychopathology are assigned to fellows for treatment. A clinical caseload at SATU includes both individual and group clients and ranges from 15-20 cases for a Primary Placement fellow and 3-5 cases for a Secondary Placement fellow. SATU faculty members provide supervision, support and guidance around caseload management and offer specialized training to fellows in Motivational Interviewing and Cognitive Behavioral Therapy.

Evidence-Based Practices

The following evidence-based practices (EBPs) are used in this placement setting: Cognitive Behavioral Therapy (CBT); Motivational Interviewing (MI); Relapse Prevention; Mindfulness for Relapse Prevention (MDRP); 12 Step Facilitation; Psychodynamic Therapy for Addiction; and Auricular Acupuncture.

Psychological Assessment

Both primary and secondary fellows at the Substance use and AddictionTreatment Unit will conduct a number of brief assessments to screen for mental health and substance abuse symptoms (e.g. Beck Depression Inventory, Beck Anxiety Inventory, PHQ-9). In addition, fellows in their triage role will routinely conduct thorough clinical interviews in a fast-paced environment. These assessments often include a medical record review.

During the training year fellows will also conduct two comprehensive assessments of their choosing. These may include: 1) general assessments for intellectual and personality functioning, and skills and vocational functioning; or 2) more specialized assessments that focus on substance use, trauma, pain, sleep, and eating to help guide treatment planning. For those fellows interested in more formal psychometric assessment opportunities, specialized supervision is available to meet those learning objectives.

Diversity

The internship affords the opportunity to work with a wonderfully diverse client community comprised of individuals who vary as to age, gender, race, ethnicity, sexual orientation, gender identity, socio-economic, disability, deaf and hard of hearing, culture, geography, and country of origin. SATU clients hail from Connecticut, other states, and other continents, including South America, Africa, and Asia. The clinic utilizes interpreter services and technology to facilitate therapeutic services in a client’s preferred language. Fellows are encouraged to seek out first-hand knowledge of the various New Haven neighborhoods to develop a unique understanding of the environment in which clients live. In addition, fellows often attend 12 step meetings embedded within these home communities as a way to understand the language and culture of addiction and recovery.

Scholarly Activity

Scholarly projects at SATU involve the opportunity to work with talented faculty from the Division of Addictions. Fellows can learn about the following ongoing research: behavioral pharmacology and medications development; psychotherapy treatment development and efficacy; patient treatment matching and process research; stress; self-control and addictive Behaviors; diagnostic, epidemiological and policy studies; international research; primary care interventions; and HIV risk reduction.

More specifically, fellows have the opportunity to conduct manually driven psychotherapy, attend research seminars and meetings, and participate in scholarly projects through the Psychotherapy Development Research Center. This is the only National Institute on Drug Abuse (NIDA) Center focused exclusively on psychotherapy development clinical research. The Center aims to catalyze innovative and efficacious psychotherapies that have promise for real world implementation.

Faculty

• Donna LaPaglia, PsyD, ABPP, Primary Advisor
• Matthew Steinfeld, PhD, Supervisor
• Brian Kiluk, PhD, Supervisor

Supervision

Fellows obtain both individual and group supervision for their clinical work. Fellows meet regularly with a primary advisor, several clinical supervisors, an assessment supervisor (as needed), and may pursue a research mentor from a faculty group of over 20 full-time psychologists within the Division of Addictions. Formal evaluations are completed that serve as opportunities to review progress on training goals and achievement of core competencies.

Seminars and Specialized Training

In addition to the Core Seminar, fellows at this placement may participate in the following Division of Addictions seminars: Psychotherapy for Substance Use Disorders, Special Populations in Addictions Treatment, and Psychotherapy Research and Addiction Psychiatry. In addition, specialized psychotherapy training and supervision is offered by expert faculty in evidenced based interventions. Fellows also receive certification in auricular acupuncture, an adjunctive intervention offered in the clinic for relief of withdrawal symptoms and anxiety, and help with craving. Fellows also participate in a yearlong psychotherapy case seminar to support the development of enhanced conceptualization and psychotherapy skills.

Applicant Qualifications

Strong applicants for this placement generally have experience working with adults with substance use disorders and mental illness. In addition, strong applicants will have experience conducting intake assessments and providing evidence-based group therapy with substance using populations. Fellows who match with this placement typically have a strong interest in addiction services and scholarship and their future goals often include providing clinical services, conducting research, and pursuing leadership opportunities.

Applicants selected for this placement must successfully pass background checks conducted by Yale University. Since this placement requires travel between different training sites, previous fellows have considered it essential to have access to their own car.

For Further Information

Contact Dr. Donna LaPaglia at donna.lapaglia@yale.edu.